Lead RN Reviewer

Define Ventures; United States; On-site; USD 73,000 - 77,000; Full time

Benefits offered by this job

Medical, dental, vision

401K with company match

PTO 23 days

Parental leave

Pet insurance

Job summary

Cohere Health is seeking a Lead RN Reviewer to supervise and mentor an RN team within Service Operations. You will coach staff, audit quality, and drive performance against metrics using established operational tools.

You will report to the Clinical Supervisor and partner with leadership to improve clinical outcomes. The role is fully remote with travel around 5% and a comprehensive benefits package including health, 401k, PTO, parental leave, and more.

Qualifications

• 5+ years in healthcare, managed care, or insurance-related roles.
• 1–2 years in a lead or supervisory capacity, with experience coaching or training others.
• A current, active RN license (BSN preferred).
• Utilization Management experience required.
• Comfort interpreting operational data and metrics to identify process improvements.

Responsibilities

• Provide general supervision over the nursing staff, including interviewing new hires, training, coaching, mentoring, quality auditing and oversight of quality improvement plans.
• Coordinate and provide day-to-day oversight and direction to clinicians.
• Assist in addressing case escalations or provider issues.

Skills

Healthcare experience

Leadership

Data interpretation

Communication skills

Remote leadership

Education

RN license

BSN preferred

Job description

Opportunity Overview:

Cohere’s Service Operations team is responsible for ensuring that our healthcare partners are supported throughout their lifecycle of using the platform. The Lead RN Reviewer in Service Operations position is a crucial role in our organization. In this role, you are responsible for coaching, mentoring, evaluating and developing the RN team. TheLead RN Reviewer will use established operational tools to ensure all RN staff are meeting or exceeding performance metrics and quality standards established by the leadership team.

As a Lead RN Reviewer, you will work closely with the leadership team and report to the Clinical Supervisor of Service Operations. You will be responsible for providing supervision for the RN Reviewers to meet or exceed operational objectives and metrics. You will leverage both your creative skills and communication skills to promote a high performing clinical team. At a growing organization, this is a position that offers the ability to make a substantive mark on the company and its partners with exponential growth opportunities.

What you’ll do:

• Gain a deep understanding of Cohere’s product and our health plan partners
• Provide general supervision over the nursing staff. This includes interviewing new hires, training, coaching, mentoring, quality auditing and oversight of quality improvement plans initiated by the Clinical Supervisor and or Director.
• Coordinates and provides day-to-day oversight and direction to clinicians
• Assist in addressing any case escalations or provider issues
• Other duties as assigned

What you’ll need:

• 5+ years in healthcare, managed care, or insurance-related roles
• 1–2 years in a lead or supervisory capacity, with experience coaching or training others
• A current, active RN license (BSN preferred)
• Utilization Management experience required
• Comfort interpreting operational data and metrics to identify process improvements
• Excellent communication, collaboration, and organizational skills
• A kind, patient, and flexible leadership style suited for a remote, fast-paced environment

Pay & Perks:

Fully remote opportunity with about 5% travel

Medical, dental, vision, life, disability insurance, and Employee Assistance Program

401K retirement plan with company match; flexible spending and health savings account

Up to 184 hours (23 days) of PTO per year + company holidays

Up to 14 weeks of paid parental leave

Pet insurance

The salary range for this position is $35 to $37 hourly; as part of a total benefits package which includes health insurance, 401k and bonus. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.

Interview Process*:

1. Connect with Talent Acquisition for a Preliminary Phone Screening
2. Internet Speed Test Take Home Assignment
3. Meet your Hiring Manager!

*Subject to change

About Cohere Health:

Cohere Health’s clinical intelligence platform delivers AI-powered solutions that streamline access to quality care by improving payer-provider collaboration, cost containment, and healthcare economics. Cohere Health works with over 660,000 providers and handles over 12 million prior authorization requests annually. Its responsible AI auto-approves up to 90% of requests for millions of health plan members.

With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.

Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners, Cohere Health drives more transparent, streamlined healthcare processes, helping patients receive faster, more appropriate care and higher-quality outcomes.

The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.

We can’t wait to learn more about you and meet you at Cohere Health!

Equal Opportunity Statement:

Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, it’s personal.

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